Individual
MRS. KEATRINA MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010
(381) 483-5020
Mailing address
PO BOX 4781, PINEVILLE, LA 71361-4781
(318) 473-0010
(318) 483-5020
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13258
LA
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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